Muhammad Umar Farooq, Murtaza Ahsan Ansari, Iqbal A Muhammad Khyani.
Role of Mitomycin C in Endoscopic Management of Nasolacrimal Duct Obstruction.
J Dow Uni Health Sci Jan ;7(2):63-7.

Objective: To study the effects of mitomycin C in prevention of recurrent stenosis adhesion formation inendoscopic management of obstructed nasolacrimal duct.Study Design: Quasi experimental design.Place & Duration: The study was conducted at the department of ENT-Head & Neck Surgery, Dow Universityof Health Sciences, Karachi from September 2002 to September 2012. Patients were selected from differenthospitals including Faiz-e-Aam Hospital, Mid City Hospital, National Medical Centre and Civil Hospital,Karachi.Subject & Methods: Clinical records of 82 patients, who were diagnosed to have nasolacrimal duct obstructionand managed by transnasal endoscopic approach, were reviewed. Participants were randomly divided in two groupsdepending upon application of mitomycin C intra-operatively. Demographic data was collected including age,gender, associated nasal pathologies, or concomitant nasal surgery performed, post operative relief of epiphora andcomplications if any, were recorded on institutional approved performa. Patients were followed up for 3 to 6 months.Surgical success was definedby complete relief from epiphora and free drainage of nasolacrimal duct, after 3 and 6 months of follow up.Results: Mitomycin C was applied in more than half of our patients 54.9 % (n=45/82). Out of which 93.3%(n=42/45) were completely relieved from epiphora within six months, and only 6.6% (n=3/45) patients haddeveloped synechiae. In contrast, 45.1 % (n=37) patient in whom mitomycin C was not applied, completerecovery from symptoms was observed in 78.3% (n=29/37), and 21.6% (n=8/37) patient had developed nasalsynechiae. The results were statistically analysed using Chi-Square test.Conclusion: Intra-operative use of mitomycin C is effective in prevention of recurrent stenosis and adhesionformation by 15%. Hence improving success rate from 78.3% to 93.3% by endoscopic surgery. But scar-lesssurgery, preservation of medial canthal structures and lacrimal pump system, short surgical time and hospitalstay, are the added advantage of endoscopic sinus surgery. Nasal problems can also be corrected in the sameoperation, hence further improving results.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com